{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T09:15:31Z","timestamp":1782465331325,"version":"3.54.5"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T00:00:00Z","timestamp":1736553600000},"content-version":"vor","delay-in-days":117,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>A 33-year-old female presented with coryzal symptoms, facial swelling, severe haemorrhagic stomatitis, blistering oral mucositis, conjunctival injection and a sparse targetoid rash on the back and face, requiring admission to hospital. She had received the seasonal influenza vaccination 3 days prior to feeling unwell. Differential diagnosis included erythema multiforme major (EMM) secondary to the influenza vaccine or Mycoplasma pneumoniae-induced rash and mucositis (MIRM). Oropharyngeal swabs were negative on PCR for cutaneous viruses and Mycoplasma pneumoniae (MP). A skin biopsy from a targetoid lesion on the body showed full thickness epidermal necrosis with epidermal\u2013dermal clefting, numerous civatte bodies and a moderate perivascular infiltrate of lymphocytes and plasma cells in the papillary dermis. She was successfully treated with oral prednisolone and azithromycin. Following discharge from hospital, the paired serological testing for MP returned positive, confirming a diagnosis of MIRM. Our case highlights the difficulties in detecting MP as two diagnostic methods yielded different results, and so we advocate performing both MP PCR and serology to maximise the yield and speed of diagnosis. Secondly, our case highlights the clinical challenge in differentiating MIRM from EMM or Stevens\u2013Johnson syndrome, particularly if there is a potential drug trigger (in our case the influenza vaccine), as all these conditions can feature a severe mucositis with often indistinguishable histological findings. Correct diagnosis of MIRM is important for appropriate and timely administration of anti-MP antibiotic therapy to facilitate recovery and minimise complications.<\/jats:p>","DOI":"10.1002\/ski2.459","type":"journal-article","created":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T12:36:11Z","timestamp":1726576571000},"source":"Crossref","is-referenced-by-count":1,"title":["A Case of Mycoplasma Pneumoniae-Induced Rash and Mucositis with Recent Influenza Vaccination"],"prefix":"10.1093","volume":"4","author":[{"given":"Vani","family":"Agarwal","sequence":"first","affiliation":[{"name":"Department of Dermatology, Imperial College Healthcare NHS Trust , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgie","family":"Gamble","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Imperial College Healthcare NHS Trust , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Amphlett","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Imperial College Healthcare NHS Trust , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2613-6056","authenticated-orcid":false,"given":"Neil P.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Imperial College Healthcare NHS Trust , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,9,16]]},"reference":[{"key":"2025112606020575800_ski2459-bib-0001","article-title":"Mycoplasma infections","author":"Lanao","year":"2023","journal-title":"StatPearls"},{"issue":"2","key":"2025112606020575800_ski2459-bib-0002","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1016\/j.jaad.2014.06.026","article-title":"Mycoplasma pneumoniae-induced rash and mucositis as a syndrome distinct from Stevens\u2013Johnson syndrome and erythema multiforme: a systematic review","volume":"72","author":"Canavan","year":"2015","journal-title":"J Am Acad Dermatol"},{"key":"2025112606020575800_ski2459-bib-0003","article-title":"Mycoplasma pneumonia-induced rash and mucositis (MIRM)","author":"Frantz","year":"2024","journal-title":"StatPearls"},{"issue":"1","key":"2025112606020575800_ski2459-bib-0004","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.jaad.2018.03.013","article-title":"Clinical and histologic features of Mycoplasma pneumoniae\u2013related erythema multiforme: a single-center series of 33 cases compared with 100 cases induced by other causes","volume":"79","author":"Amode","year":"2018","journal-title":"J Am Acad Dermatol"},{"issue":"3","key":"2025112606020575800_ski2459-bib-0005","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1111\/ced.14404","article-title":"Reactive infectious mucocutaneous eruption: Mycoplasma pneumoniae-induced rash and mucositis and other parainfectious eruptions","volume":"46","author":"Ramien","year":"2021","journal-title":"Clin Exp Dermatol"},{"issue":"7","key":"2025112606020575800_ski2459-bib-0006","article-title":"Stevens\u2013Johnson syndrome due to influenza vaccination","volume":"12","author":"Tong","year":"2020","journal-title":"Cureus"}],"container-title":["Skin Health and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/skinhd\/article-pdf\/4\/6\/ski2.459\/61412342\/skinhd_4_6_e459.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/skinhd\/article-pdf\/4\/6\/ski2.459\/61412342\/skinhd_4_6_e459.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T11:02:15Z","timestamp":1764154935000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/skinhd\/article\/doi\/10.1002\/ski2.459\/7950907"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,16]]},"references-count":6,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,9,16]]},"published-print":{"date-parts":[[2024,12,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ski2.459","relation":{},"ISSN":["2690-442X"],"issn-type":[{"value":"2690-442X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,12]]},"published":{"date-parts":[[2024,9,16]]},"article-number":"ski2.459"}}